Peritoneal Cancer Index (PCI)

The Peritoneal Cancer Index (PCI) is a scoring system surgeons use to measure how much tumor is present inside the abdomen and how widely it has spread across the peritoneum. The abdomen is divided into 13 regions, each scored from 0 to 3, producing a total score from 0 to 39. A lower PCI generally means less disease and a better chance that surgery can remove all visible tumor.

Origin

The PCI was developed by surgical oncologist Dr. Paul Sugarbaker in the early 1990s at the Washington Cancer Institute as part of his pioneering work on cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies. It has since become the standard tool for quantifying peritoneal tumor burden worldwide.

Significance in Asbestos Context

For patients with peritoneal mesothelioma, the form of asbestos-related cancer that grows in the abdominal lining, the PCI is one of the single most important numbers in determining treatment and prognosis. Surgeons use it to decide whether a patient is a candidate for cytoreductive surgery with HIPEC, the treatment that has produced the longest survival times in peritoneal mesothelioma. A lower PCI (often under 20) combined with the ability to achieve complete cytoreduction is associated with markedly better outcomes, while a very high PCI may indicate that surgery would not be beneficial. Patients should ask whether their surgeon documented a PCI score during diagnostic laparoscopy or surgery, because this number frequently appears in operative reports, oncology consultations, and life expectancy assessments that can also be relevant to a legal claim.

Example Sentence

After her diagnostic laparoscopy, the surgeon told her that her Peritoneal Cancer Index was 14, which made her a strong candidate for cytoreductive surgery with HIPEC.

Related Terms

Peritoneal Mesothelioma, Cytoreductive Surgery, HIPEC, Completeness of Cytoreduction Score, Diagnostic Laparoscopy, Peritoneum

Notes

• Ask your surgical oncologist what your PCI score is and request that the score and the regional breakdown be included in your operative report and discharge summary.
• If you are being evaluated for cytoreductive surgery and HIPEC, seek consultation at a high-volume peritoneal surface malignancy center, as accurate PCI scoring depends heavily on surgeon experience.
• The PCI is often paired with a Completeness of Cytoreduction (CC) score after surgery; ask about both, because the CC score (ideally CC-0 or CC-1) is an even stronger predictor of survival.
• Preserve all operative reports, laparoscopy findings, and imaging that mention PCI or tumor distribution. These documents matter for both your ongoing medical care and any asbestos claim involving life expectancy or damages.